Provider Demographics
NPI:1205964756
Name:WILLIAM L. DOWDEN, M.D. AND DAVID S. KIRN, M.D., PSC
Entity type:Organization
Organization Name:WILLIAM L. DOWDEN, M.D. AND DAVID S. KIRN, M.D., PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOWDEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:859-277-9435
Mailing Address - Street 1:715 SHAKER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3662
Mailing Address - Country:US
Mailing Address - Phone:859-277-9435
Mailing Address - Fax:859-277-8852
Practice Address - Street 1:715 SHAKER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3662
Practice Address - Country:US
Practice Address - Phone:859-277-9435
Practice Address - Fax:859-277-8852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65931040Medicaid
KY05488Medicare ID - Type UnspecifiedGROUP NUMBER